Endovascular stent-grafts for superficial femoral artery disease: results of 1-year follow-up

PURPOSE: To document a preliminary study to assess the deployment and outcomes of endoluminal stent grafting in the superficial femoral artery (SFA) with use of a prototype device. MATERIALS AND METHODS: Twenty patients with lifestyle-limiting intermittent claudication were selected for treatment with a balloon-mounted expansive polytetrafluoroethylene graft. All patients had angiographically proven SFA disease (median length, 17 cm) with normal arterial inflow and at least two calf vessels patent to the ankle. Follow-up was by means of ankle brachial pressure index (ABPI), duplex ultrasound, and angiography. RESULTS: Fourteen patients were successfully treated. Six patients were excluded: five by the study protocol and one because the procedure was a technical failure. ABPI rose from 0.6 before treatment to 1.0. The treated limbs became asymptomatic. Twelve-month primary, primary assisted, and secondary patency rates of treated patients were 29%, 50%, and 64%. CONCLUSION: Endovascular stent grafting of SFA lesions is technically feasible, but the patency rates obtained with this design are inferior to those obtained with conventional surgical bypass.     

Serum interleukin 2 receptor levels in childhood acute lymphoblastic leukemia

The clinical significance of interleukin 2 receptor (IL2R) concentrations in serum was determined for 344 children with newly diagnosed acute lymphoblastic leukemia (ALL). Serum levels of IL2R in patients (267 to 80,000 U/mL, median 2,007 U/mL) were significantly higher than normal control values (170 to 738 U/mL, median 347 U/mL) (P less than .0001). Measurements in cases of T cell ALL were lower than in the non-T, non-B cases (P = .02). Among the 264 patients with non-T, non-B ALL, but not in those with T cell disease, higher serum IL2R levels (greater than 2,000 U/mL) were associated with a poorer treatment outcome (P = .04). In a multivariate analysis, serum IL2R level contributed independent prognostic information beyond that conveyed by leukocyte count, race, and age (P = .04). One explanation for these results is that soluble IL2R competes with normal lymphocyte- integrated IL2R for the ligand and thus could suppress host antitumor immunity.     

A model for compound action potentials and currents in a nerve bundle III: A comparison of the conduction velocity distributions calculated from compound action currents and potentials

In this paper, we present the experimentally measured Compound Action Current (CACs) and Compound Action Potentials (CAPs) from frog sciatic nerves and earthworm nerve cords. We used histologically prepared cross sections of these nerve bundles to determine the distribution of fiber diameters. A modified volume conduction model that includes frequency-dependent conductivities was used to compute the Single Fiber Action Signals (SFASs). The recorded CACs and CAPs are used to predict the Conduction Velocity Distributions (CVDs) from the nerve bundles. The predicted CVDs are then compared with the histological CVDs. Analysis of Compound Action Signals from the three giant axons in the earthworm nerve cord and microelectrode data for the transmembrane action potential demonstrate the validity of our mathematical model. We found that the CVDs predicted from the recorded CACs and CAPs differ from the histological CVD for a variety of reasons. The validity of the assumption of a linear relationship between axon diameter and conduction velocity of a propagating action signal was investigated using CVDs from both the CAC and CAP. Variations of the CVDs with the propagation distance of the CASs and the recording temperature were investigated.     

Pragmatic trials in primary care. Methodological challenges and solutions demonstrated by the DIAMOND-study

Background  

Pragmatic randomised controlled trials are often used in primary care to evaluate the effect of a treatment strategy. In these trials it is difficult to achieve both high internal validity and high generalisability. This article will discuss several methodological challenges in designing and conducting a pragmatic primary care based randomised controlled trial, based on our experiences in the DIAMOND-study and will discuss the rationale behind the choices we made. From the successes as well as the problems we experienced the quality of future pragmatic trials may benefit.     

tdic(9;12): a nonrandom chromosome abnormality in childhood B-cell precursor acute lymphoblastic leukemia: a Pediatric Oncology Group Study

In a review of 432 children with newly diagnosed acute lymphoblastic leukemia (ALL), we identified a new nonrandom translocation, tdic(9;12)(p1?1;p1?2), in the leukemic marrow cells of eight patients. Seven had hypodiploid karyotypes that lacked chromosomes 9 and 12 and contained a der(12), tdic(9;12); the eighth had a pseudodiploid karyotype with two normal 9 chromosomes, one normal 12 and the der(12), tdic(9;12). Abnormalities involving chromosomes other than 9 and 12 were noted in four of the eight patients. All cells with the tdic(9;12) expressed both the common ALL antigen and HLA-DR. Cytoplasmic immunoglobulin, a marker of pre-B ALL, was detected in one case with the tdic(9;12) but was absent in the other seven. Our results suggest that the tdic(9;12)(p1?1;p1?2) rearrangement is specifically associated with leukemic B cell precursors.     

Pituitary adenomas: high-resolution MR imaging at 1.5 T

The magnetic resonance (MR) images of 28 patients with surgically confirmed pituitary adenomas were retrospectively evaluated. The examinations were performed on a 1.5-T superconducting MR system using a multisection spin-echo technique with 3-mm-thick sections and a 256 X 256 matrix. T1- and T2-weighted images were obtained in sagittal and coronal planes. The MR findings were correlated with detailed operative reports and diagrams. There were 11 microadenomas and 17 macroadenomas. Ten of the microadenomas and all of the macroadenomas were accurately localized and their extent delineated, particularly on T1-weighted coronal sections. Adenomas typically appeared hypointense on T1-weighted coronal sections. The appearance on T2-weighted images was variable, and generally the lesions were less well seen. Involvement of parasellar structures, particularly the optic chiasm and cavernous sinuses, was accurately depicted. Cyst formation and hemorrhage could be characterized in some instances. In general, there was excellent correlation between MR imaging and operative findings.     

人工风寒环境对小鼠单核巨噬细胞系统吞噬功能的影响

我们将小鼠置于人工风寒环境中刺激１０ｈ后，观察到其网状内皮系统（ＲＥＳ）廓清功能及φ腹腔巨噬细胞φ（ＰＭ噬）释放Ｈ２Ｏ２量均受到明显抑制，动力学观察结果表明，免疫抑制高峰发生在风寒刺激后第３天，刺激后第５天、第７天逐渐恢复正常，表现出一过性免疫抑制。免疫抑制的原因可能是风寒刺激过程中应激激素大量分泌所致。提示中医六气病因学说中的风寒二气，其致病的作用机理可能与抑制机体非特异性细胞免疫功能有关，该结     

红豆杉中二个新紫杉烷二萜化合物的分离与测定

从红豆杉Taxus chinensis(Pilger)Rehd。树皮中得到二个新的紫杉烷类化合物,它们的结构为1-羟基-7,9-二去乙酰基巴卡亭Ⅰ(1—hydroxy-7,9—dideacetyl—baccatin Ⅰ)和7,9-二去乙酰基巴卡亭Ⅵ(7,9-dideacetyl baccatin Ⅵ).